A Closer Examination of the HIV/Fertility Linkage ... - Measure DHS

DISCUSSIONExamination of trends in these three countries shows suggestive patterns of fertility stalling inthe countries with HIV epidemics that have reached HIV prevalence rates over 10%. Trends inZimbabwe and Uganda suggest that fertility behaviors are changing during the epidemic.Burkina Faso does not experience the same effects as the other two countries; this could indicatethat this country’s HIV epidemic is not severe enough to causes changes in fertility.The patterns we discuss certainly do not fully explain the links between HIV and fertility.However, the trends in Zimbabwe and Uganda (and their lack in Burkina Faso) suggest that theHIV epidemic may play a part in fertility patterns. The reduction or lack of increase incontraceptive use, particularly among the urban populations, suggests that women may be tryingto have more children. This theory is supported by the lack of decline in the ideal number ofchildren, and the slowing declines in fertility rates. While Uganda appears to have astraightforward decline in contraceptive use that could explain the lack of fertility decline,Zimbabwe’s patterns are more complex. Zimbabwe may be experiencing a process in whichwomen attempt to avoid HIV while having many children; they may do so by confining sex tomarriage. Their contraceptive use may be to space births, rather than to limit childbearing.36